1985, 10-22 Permit App: 00008405 Residence• (THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
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Owner's Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Numbe ' Zip
N. 5013 Burns Rd. Spokane, Washington 99216
Applicant
TUPPER INC.
Address
E. 12929 Sprague Ave.
City
Spokane
State
Washington
Zip
99216
Phone
( 509) 928-1991
Business Phone
( 509) 928-1991
Contractor /Agent
TUPPER INC.
Address
E. 12929 Sprague Ave.
City
Spokane
State
Washington
Zip
99216
Phone
( 509 ) 928-1991
Contact
Ken or Debbie
License Number (Required)
TUPPEIR179DC
Business Phone
( 509> 928-1991
Architect /Engineer
Address
City
State
I Zip
Phone
( )
Contact
Business Phone
( )
Lender
Address
City
State
Zip
Phone
Describe Wort
Single Family Residence
Res.
Comm.
Subdivision/Plat Name/Short Plat Number
SUMMERFIELD EAST FIRST ADDITION
Assessor Parcel Number
35644-2611
Lot 1
11 1
Block
6
Plat Number
Pertinent File Numbers
Zone
Comp. Plan
Census Tract
Number of Dwelling Units
1
Number of Buiidings
1
Lot Size (Sq. Ft./Acre) !Depth
1
Frontage
Front Setback
Left Setback
Right Setback
Rear Setback
1
Additional information
996 main floor
1 DEPARTMENT USE
Square Footage
948 unfinished basement
484 garage
100 uncovered deck
•
Building Technician
Date
GroupT•
Type
DEPARTMENTAL REVIEW
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent is true, correct, legal, and binding.
Owner's Signature
Date / 1 ���
Cond.
Approved Approval
Hold
Environmental Health Permit Number
W. 1101 College
Room 200
e.5 7-7-7-- I
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Planning/Zoning
N. 721 Jefferson
1
Engineers Permit Number
N. 811 Jefferson
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MA Cpw(P
Utilities
N. 811 Jefferson
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Plan Review/FIre Prevention
N. 811 Jefferson
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Address
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent is true, correct, legal, and binding.
Owner's Signature
Date / 1 ���
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ADDRESS N. 5
13 BURNS RD
STYLE HOME 2200-D
LEGAL DESCRIPTION L11 B6 SUMMERFIELD EAST FIRST ADDN.
APPLICANT
TUP R INC
JOB NO. 538
FHA CASE NO.
POWER W.W.P.
WATER TRENTWOOD
SCALE 1"=20'
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